Talk:Chloroquine/Archive 1

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related to Primaquine —Preceding unsigned comment added by 151.197.240.112 (talk • contribs) 08:12, 19 April 2005

Nick, do you have a good source for the RA mechanism, eg textbook or journal article? JFW | T@lk  13:07, 11 July 2005 (UTC)

A discussion of the retinal toxicity may be helpful for readers. —Preceding unsigned comment added by 216.165.126.18 (talk • contribs) 05:40, 13 April 2006
 * I have added a remark about retinal toxicity in the side-effect section. Ruerd 15:40, 6 December 2006 (UTC)

It is important to clearly state the mental side-effects of chloroquine: nightmares, sleep deprivation, anxiety, depression, panic attacks, psychosis. when I was 18 on my year off, the side-effects had been played down as being "changes in moods" "stomach upsets" on the notice included in the box. the side-effects being played down, my doctor actually prescribed me a year's dosage to be taken within six months for extra protection, and I became fully aware of mysteriously and peculiarly feeling tangibly unwell in paradisiac surroundings after only one month and only found the cause four months later. this is why it is important not to play down side-effects. alongside being in unfamiliar surroundings for months, it may be hard to detect any changes unless they are explicitly stated. if people experience serious levels of anxiety and depression and have not had such feelings before, they may not associate it with medication unless it is explicitly stated. I trusted the medication and was worried about malaria, the result of not being informed of the side effects combined with bad luck on my holiday were very serious indeed, I quit my fabulous course at the University of Edinburgh after two years and would have taken another year and a half in familiar surroundings to fully recover in optimal conditions.

I have personally seen a lot of people come back from holiday in very poor shape and although no clinical studies of association have been published, caution should be explicitly overstated if anything. furthermore the effects of such depressions may take years to lift. —Preceding unsigned comment added by Gt jaya (talk • contribs) 09:22, 21 October 2006

also for some reason the side-effects of hair loss and liver damage and not mentioned on the web page. —Preceding unsigned comment added by Gt jaya (talk • contribs) 10:03, 21 October 2006

Hi, I too have heard a lot of rumors of liver diseases from chloroquine, and I've been on it for about 7 months now. I'd like some information on it if anyone has it. Are the rumors completely unfounded? Thanks --gloushire 17:40, 28 April 2007 (UTC)

The article has nothing about the invention of this medicine.This site: [CDC and Chloroquine] tell that this medicine was invented in 1934, in Germany. —Preceding unsigned comment added by Agre22 (talk • contribs) 23:57, 29 May 2009 (UTC)

The phrase "eastern America", which is not in normal usage, is used in the Resistance section. Please revise this phrase to describe accurately the region intended. At present it could refer to eastern USA, east coast of N or S America, etc. etc. Thank you. Hambleton (talk) 15:25, 17 December 2009 (UTC)

I think the author meant "East Africa" instead, otherwise it makes little sense. I am afraid the whole section on resistance is lacking. Chloroquine resistance was not slow in developing: introduced in 1945, drug resistance was reported only 12 years later (see for example Wongsrichanalai C, Pickard AL, Wernsdorfer WH, Meshnick SR. Epidemiology of drug-resistant malaria. Lancet Infect Dis. 2002 Apr ;2(4):209-218.). Its spread is far wider than the article gives away: it is practically useless for P falciparum throughout South-East Asia and New Guinea, and large parts of East Africa and South America. Furthermore, it has arisen independently in multiple geographies (see for example Mita T, Tanabe K, Kita K. Spread and evolution of Plasmodium falciparum drug resistance. Parasitol. Int. 2009 Sep ;58(3):201-209). There is a well-known locus of Chloroquine resistance in the P falciparum PfCRT gene; in addition, copy number variations of the PfMDR1 gene is known to contribute to CQ resistance, and it is likely there are additional genomic components, not yet characterized. 129.67.45.68 (talk) 15:57, 18 January 2010 (UTC)

Refactoring Antivirus section
I have slightly refactored and improved the Antiviral section. Reversions included a sentence where the original editor clearly meant the topic drug but named a different drug.

My changes were reverted by without a reason given. So I have re-reverted and created this section to discuss if needed.

If someone can better re-structure the headings back to two-levels, in a way that makes sense, but preserves the importance of the SARS-CoV-2 research, please do. — Preceding unsigned comment added by 147.12.212.215 (talk) 18:31, 8 March 2020 (UTC)

Would like to link to COVID-19 Repurposing Drug article section on Chloroquine
I want to link the COVID-19 section of the article to https://en.wikipedia.org/wiki/COVID-19_drug_repurposing_research#Chloroquine

What's the best way of doing this? ProbablyAndrewKuznetsov (talk) 21:11, 21 March 2020 (UTC)
 * I have removed the Chloroquine section from the COVID-19 drug repurposing research article because it was, as I said in my edit summary: "sourced solely to Chinalawtranslate.com, which incorporates user-generated content, and states: "All translations on this site are unofficial and are provided for reference purposes only. These translations are created and continuously updated by users". Per WP:USERGENERATED, this is is an unreliable source, as is Wikipedia itself." Carlstak (talk) 22:47, 21 March 2020 (UTC)


 * Thanks for taking a look over. I've readded the Choloroquine section with a reference to Wang, Manli; Cao, Ruiyuan; Zhang, Leike; Yang, Xinglou; Liu, Jia; Xu, Mingyue; Shi, Zhengli; Hu, Zhihong; Zhong, Wu; Xiao, Gengfu (arch 2020). "Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro", which I believe addresses the credibility concerns. ProbablyAndrewKuznetsov (talk) 23:14, 21 March 2020 (UTC)


 * Please familiarize yourself with policy on editing articles with biomedical information, per WP:MEDRS "all biomedical information must be based on reliable, third-party published secondary sources, and must accurately reflect current knowledge...Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals...Primary sources should generally not be used for medical content – as such sources often include unreliable or preliminary information, for example early in vitro results which don't hold in later clinical trials." Carlstak (talk) 23:32, 21 March 2020 (UTC)

The study does not show that it helps. Virus concentration drops in the upper respiratory system early in the disease aanyways. And they measured just that. They should have measured virus load in the lungs, but didn't. Given that Chloroquine has massive, partially permanent psychological side effects, that its a GABA antagonist and that it somewhat resembles the dangers of the Quinolone antibiotic toxicity, you absolutely don't want to use it here.

COVID-19
A study shows that this drug is also effective against SARS COVID -19. Rethvik (talk) 06:01, 18 March 2020 (UTC)

NO IT DOES NOT SHOW THAT!!!! That study is massively flawed. It shows nothing. Please don't use this placebo in Covid-19. It has such a massive amount of permanent psychological side effect and it does not help. It resembles some of the permanent toxicity of the Fluorchinolones    — Preceding unsigned comment added by 79.235.125.127 (talk) 07:24, 22 March 2020 (UTC)

Nothing about the French studies
Hello, There is nothing about French research studies about chloroquine lead by Didier Raoult (https://en.wikipedia.org/wiki/Didier_Raoult#COVID-19). — Preceding unsigned comment added by 176.160.77.94 (talk) 16:21, 22 March 2020 (UTC)
 * The study is unpublished and has not been peer reviewed -- Guerillero &#124;  Parlez Moi  17:31, 22 March 2020 (UTC)

No Reason to think, that Chloroquine has benefits in Covid-19
SARS-2 pandemic is devastating and the number of people, suffering from covid-19 is increasing exponentially. This leaves us in a helpless situation, since there is no widely available medicine. Despite two promising therapeutic candidates (a SARS-1 monoclonal antibody that works for SARS-2, too and the serine protease inhibitor Camostat Mesylate) people are now desperately trying all kinds of substances.

This is usually started by giving that substance in vitro to cell cultures that are infected by the virus. A good candidate for further research is a substance that reduce virus replication on the nano molar scale, e.g. only very tiny amounts of that substance are necessary.

Note: For Chloroquine there was no nano molar effect, but only a micro molar effect. This already hints that massive doses must be used in vivo, e.g. in the human body!

This in itself says nothing about the actual usability of such a substance in living organisms, due to various reasons. One is, that the substance must reach and enter the cell.

Note: Chloroquine does not reach infected lung cells easily. Hence even higher doses might be required!

So despite this unfavorable situation, researcher tried Chloroquine in a study.

However that study was not randomized controlled, double blind, because the two groups were not chosen at random, but the group that took the chloroquine was more ill on avarage and was later in the progression of the disease.

Now what they found was, that the virus load in the upper respiratory decreased in that group more then in the control group. And then they made the false conclusion that this was because of the chloroquine.

This has two problems that render the study useless:

1.) Both groups where not random, but the control group was in an earlier stage.

1.) Covid-19 starts with a high load of virus in the upper respiratory system and then the load is shifted more and more deeper into the lungs. After approx. a week the virus concentration in the upper respiratory system drops significantly, whether treated or not. This has nothing to do with Chloroquine.

--

So we can not conclude anything about chloroquine here, but we know that if there is an effect at all, the dose must be very high. But is this worth the risk shifting the focus from more reasonable therapies?

In very high doses chloroquine has massive side effects, that you ab absolutely don't want in someone with severe Covid-19 symptoms. Weight that against the reasonable possibility that its nothing but a placebo against SARS-2.

So, please people stop spreading this Chloroquine route! Focus on something else and save those peoples live, who while having SARS, also get massive chloroquine side effects. — Preceding unsigned comment added by 79.235.125.127 (talk) 08:17, 22 March 2020 (UTC)
 * Your title and information are misleading. There is reason to think that Chloroquine has benefits in Covid-19, which is why the CDC, among others, are conducting trials. 92.25.47.124 (talk) 13:43, 24 March 2020 (UTC)


 * The article (or a separate article?) would benefit from an overview of the reasons people put forward to promote the use of Chloroquine and an explanation why some or all of those reasons may be invalid. All using reliable sources of course. The article would not benefit from simply removing material some people happen to think is wrong. Mlewan (talk) 07:23, 25 March 2020 (UTC)
 * It is being studied. Discussion belongs in the research section. Doc James  (talk · contribs · email) 14:59, 25 March 2020 (UTC)

FDA has just issued Emergency Use Authorization (EUA) for Chloroquine
Amidst concerns about its effectiveness from scientists, FDA has just issued Emergency Use Authorization (EUA) for Chloroquine (and Hydroxychloroquine). Expect a lot more traffic, and also we should import some information from here. Thanks everyone. https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/emergency-use-authorization#2019-ncov ProbablyAndrewKuznetsov (talk) 15:38, 30 March 2020 (UTC)

Minor typo - lack authority to fix
There's a minor punctuation error in the section on COVID 19. Here is the awkward sentence, with a semi-colon where a comma should be.

"Use; however, is only recommended in the setting of an approved trial or under the details outlined by Monitored Emergency Use of Unregistered Interventions.[3]"

Thanks for everyone's work on this page. 2601:1C0:CA01:D349:A060:ECEC:713:7971 (talk) 18:16, 3 April 2020 (UTC)


 * Done thanks! -- Gtoffoletto (talk) 18:18, 3 April 2020 (UTC)

Semi-protected edit request on 3 April 2020
Change: "On 24 March 2020, it was reported that one fatality and one hospitalization, a husband and wife, due to consumption of a fish tank antiparasitic containing chloroquine phosphate with the intention of prophylaxis against COVID-19"

To: "On 24 March 2020, a husband and wife consumed a antiparastic containing chloroquine phosphate from a fish tank with the intention of it being a prophylaxis against COVID-19. This resulted in one dying and the other to be hospitalized. 84.208.62.166 (talk) 05:32, 3 April 2020 (UTC)
 * Done with some minor edits. Thanks. -- Gtoffoletto (talk) 18:22, 3 April 2020 (UTC)

About my reformatting of the headings of two former talk sections to make them part of this "Reviews" sub- section
I am boldly editting, lest this possibly crucial information possibly remain mysterious, to some non-native users of English (and also even to some of my fellow native speakers). My concern is that (even despite subject matter competence far beyond my own) their understanding might be impeded by its (strictly speaking) incoherant English syntax. That wording had, without explanation, misused (In My Not-very-Humble Opinion) the word "this", when it presented, incompletely, from a sentence it quoted from (what I presume to have been) a reliable source (though I also presume that that source did indeed use, exactly, that word). However, the quoted sentence (which we can reasonably presume was true, in its original context) became (at best) incoherant (and arguably false) in our context. Readers whose was learned as a foreign language might be confused (and at worst misled) by that quotation (here outside the original context, which surely must have been provided, in the work from which was this passage was being extracted or abstracted) i have edited it to avoid any reason for such misunderstanding of the passage; specfically, to avoiding it being understood as if it intended to imply that the table in question appears as part of the English Wikipedia (let alone in the WP article). (My belief is that no reliable technical journal would permit use of the word "this", where it did stand prior to my edit. ...I also mention that my (arguably overly conscientious) edit may deserve critical analysis, similar to that wnich was applied to Pres. Clinton's famed quibble. (I am referring to his statement, whose wording he may have intended to say approximately that those who questioned his earlier intent would be wise to consider what a person using the word "is" means by choosing it. (I was among those who believed, that his utterance of the phrase "sounded like correct English", yet could not be understood -- at least, not by most of the reasonably careful native speakers of English -- as having any clear meaning, and that his intent may have been a satirical comment that claimed that nitpicking had been done, with devious intent, by those criticizing his behavior.) --JerzyA (talk) 02:40, 9 February 2020 (UTC)

Edits from Group 6
Our group has worked together in editing information that lacks sources or citations. We have worked on citing, adding information that we believe people should know about chloroquine, such as pregnancy information, adverse effects, pharmacokinetics and pharmacodynamics. We have also edited out information that is not identified for the general public; such as studies derived from primary sources. We have edited grammar and worked on formatting. Maguro6 (talk) 05:56, 5 November 2015 (UTC)

Peer Review from Group 5
Yes the draft submission reflected a neutral point of view. Yes the points included are verifiable with cited published material. — Preceding unsigned comment added by BE5ST (talk • contribs) 05:56, 9 November 2015 (UTC) For adverse events, it would be good to include information on frequency e.g. which side effects are rare vs. common--could be less intimidating for the general public. It may be useful to add a section on potential drug interactions as well. In the PK/PD section, there is a lot of information that is very heavily chemistry-based (e.g. pKa's and percent protonation), which might not be of the greatest relevance/understandable unless you are well-versed in chemistry and pharmacokinetics. Grp05rx (talk) 22:47, 6 November 2015 (UTC)

Usage in treating Covid19
Apparently it has been used for a while now in treating Covid19 Patients. source: https://www.jstage.jst.go.jp/article/bst/advpub/0/advpub_2020.01047/_article meta-source: https://en.wikipedia.org/wiki/Coronavirus_disease_2019 I suggest this to be added to this article, but i don't think i can do it in a good quality. — Preceding unsigned comment added by 77.57.104.110 (talk) 23:53, 28 February 2020 (UTC)
 * This information is already present in the article, under "Research". It was added on February 24. Fvasconcellos (t·c) 02:25, 29 February 2020 (UTC)

NO IT DOES NOT SHOW THAT!!!! That study is massively flawed. It shows nothing. What they measured was a drop in virus load in the upper respiratory system, but this happens in the early stages of Covid-19 anyways. The virus load did not drop in the Lungs. Besides there is no theoretical reason why it should help. So Please(!) dont't spread this hoax and absolutely don't use this placebo in Covid-19. It has such a massive amount of permanent physical and psychological side effect and it does not help. It resembles some of the permanent toxicity of the Fluorchinolones

The flaws in the study were explained by the leading expert in SARS research Prof. Christian Drosten. Unfortunately so far the entire talk is in German: https://www.youtube.com/watch?v=3O6jU6VZRH4. Drostens team had developed the SARS-2 tests that are used from the biginning all over the world. — Preceding unsigned comment added by 79.235.125.127 (talk) 07:43, 22 March 2020 (UTC)


 * Prof Drosten should have his work peer reviewed, nobody cares about him here. Richiez (talk) 20:39, 3 April 2020 (UTC)

Dunno if people saw this yet - clinical study showing promising results (in pre-print) for COVID-19
Not published yet, but thought it might be good to give people here a heads up: https://www.medrxiv.org/content/10.1101/2020.03.22.20040758v2

https://twitter.com/PeterKilmarx pointed out that it seems to have beneficial results (even though the number of patients in the study is rather low - 42 (dunno if that is the treatment group, or treatment and control together). Whole thing, as I said has not been peer-reviewed / published in a journal yet, but thought it made sense to make people aware of it. Regards Sean Heron (talk) 20:03, 6 April 2020 (UTC)


 * Related chemical with a similar name. Jim.henderson (talk) 16:54, 9 April 2020 (UTC)

Semi-protected edit request on 23 April 2020
change

Chloroquine also seems to act as a zinc ionophore, that allows extracellular zinc to enter the cell and inhibit viral RNA-dependent RNA polymerase.

to

Chloroquine also seems to act as a zinc ionophore, that allows extracellular zinc ions to enter the cell and inhibit viral RNA-dependent RNA polymerase. 87.96.167.170 (talk) 20:03, 23 April 2020 (UTC)


 * . Ionophore linked, but not zinc, per WP:MOS linking guidelines. –Deacon Vorbis (carbon &bull; videos) 00:07, 24 April 2020 (UTC)

Semi-protected edit request on 4 May 2020
Requesting addition of this study at the end of the "Pharmacology" section.

A targeted metabolomics-based assay using human induced pluripotent stem cell-derived cardiomyocytes identified the structural and functional cardiotoxicity potential of chloroquine as prolonged QT interval and QRS complex, atrioventricular block, cardiomyopathy, and cardiac hypertrophy.

Troestler (talk) 01:51, 5 May 2020 (UTC)

3D molecular model
Rather than continuing the cycle of edits and reversions, can we discuss which 3D model of the chloroquine molecule to use in the infobox?

Image A was added to the article in March and while it looks great, it is not clear where the structural information comes from. That being the case, I created images B and C based on experimental data. The structure is based on an X-ray crystallographic study reported in [https://dx.doi.org/10.1074/jbc.M113.457002 ''J. Biol. Chem.'' (2013) 288, 11242-11251]. The data is freely available from PDB entry 4FGL and PDB ligand entry CLQ. Complete citations to the scientific literature are provided on the image description page, alongside a note that entry CDMQUI in the Cambridge Structural Database corroborates the key structural features in the image.

The choice of ball-and-stick model or space-filling model is a judgement call, but to my eyes it's much easier to see all the atoms and the overall shape in Image B. Space-filling images A and C are best reserved for depicting scenarios like the one in File:Cucurbit-6-uril ActaCrystallB-Stru 1984 382.jpg where the volume the molecule occupies matters.

, can you tell us the source of the structure shown in File:Chloroquine 3D structure.png? Then we can decide which image has the stronger scientific basis and therefore which one should be used in the article.

Ben (talk) 17:54, 16 May 2020 (UTC)


 * Image B is preferable and I have seen no reason for preferring A. Thincat (talk) 13:11, 27 May 2020 (UTC)

== I am surprised that this important paper from the CDC Special Pathogens Branch is not included: Martin J Vincent, Eric Bergeron, Suzanne Benjannet, Bobbie R Erickson, Pierre E Rollin, Thomas G Ksiazek, Nabil G Seidah, Stuart T Nichol: Chloroquine is a potent inhibitor of SARS coronavirus infection and spread. Virol J. 2005 Aug 22;2:69 ==

I am surprised that this important paper from the CDC Special Pathogens Branch is not included: Martin J Vincent, Eric Bergeron, Suzanne Benjannet, Bobbie R Erickson, Pierre E Rollin, Thomas G Ksiazek, Nabil G Seidah, Stuart T Nichol: Chloroquine is a potent inhibitor of SARS coronavirus infection and spread. Virol J. 2005 Aug 22;2:69 ZachWurst (talk) 16:13, 1 August 2020 (UTC)

Zinc ionosphere
While Chloroquine has not been found of value in treating Covid directly, it been described as valuable in carrying zinc into cells thus slowing the reproduction of Covid 19 virus. We need an intermediate step of therapeutic treatment before a vaccine is made available. Perhaps, someone could expand on chloroquine and hydroxychloroquine in that role.Longinus876 (talk) 09:51, 12 August 2020 (UTC)

Does hydroxychloroquine have anything to do with chloroquine ?
Nowhere in this article do i read that hydroxychloroquine is a derivative of chloroquine, or that states any link between the two. That looks pretty lousy to me. &mdash;Jerome Potts (talk) 11:54, 25 April 2021 (UTC)